Zika virus, which can be spread by mosquito found here, is cause for concern

Singapore should be concerned that the Zika virus, which is spreading throughout Latin America, may turn up here. Experts speaking to The New Paper said it is spread by the Aedes mosquito, which is found here.

The mosquito also spreads the dengue and chikungunya viruses.

Diagnosing and tackling the Zika virus, therefore, could prove to be challenging, said Professor Duane Gubler with the Emerging Infectious Diseases Programme at the Duke-NUS Medical School.

"Doctors cannot clinically differentiate the three infections. The virus could have previously been misdiagnosed as dengue. They both belong to the same genus and same family and cause a similar illness," Prof Gubler said.

The symptoms of Zika infection are similar to both dengue and chikungunya - fever with or without a rash, joint pains and headaches. But unlike dengue, there have been no deaths associated with the virus.

Until recently, few had heard of Zika and researchers did not think it was worrisome as its symptoms are usually mild.

But over the past months, Brazil and other parts of Latin America have been battling the largest Zika outbreak yet, with more than a million people infected.

Public health officials in Brazil have also found evidence that Zika may be linked to birth defects. They have seen more and more babies born with microcephaly, a congenital condition that is associated with a small head and incomplete brain development.

"Since Zika virus started to circulate, we have seen an increased number of microcephaly - this is an indirect association," said Professor of Infectious Diseases at Nanyang Technological University's Lee Kong Chian School of Medicine Annelies Wilder-Smith.

"In some cases, Zika virus was confirmed in the (newborn) with malformations and microcephaly. This virus seems to go into the nervous system, but fortunately much less frequently than the Japanese encephalitis virus."

Prof Wilder-Smith also said Singapore "should be concerned".

With globalisation, it is a matter of time before the first imported case of Zika infection is found in Singapore.

"It could be spread because the population here is totally non-immune… to the Zika virus. Fortunately for us, the air travel connectivity between current Zika virus endemic countries and Singapore is not very strong," she added.

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According to the National Environment Agency, the Aedes mosquitoes are breeding in growing numbers in Singapore, due to record high temperatures.

With dengue cases skyrocketing as the weeks go by, infectious disease doctor Wong Sin Yew said "we should always be worried about introduction of any new pathogen to Singapore".

"I am sure that the authorities are monitoring the situation but you can always check your exposure by doing blood tests to confirm if you have antibodies to Zika virus," he added.

Prof Gubler, who also chairs the National Environment Agency's Dengue Expert Advisory Panel, agrees that doctors need to stay vigilant while considering Zika in their diagnoses.

He said doctors should "test for all three infections" but if costs are a concern, test for dengue first as it is the most common mosquito-borne disease here.

Having ruled dengue out, the next tests should be for chikungunya, and if that too is negative, Zika.

He said authorities need to intensify mosquito control, and researchers need to look at developing a vaccine for the virus, as well as engage genetically modified mosquitoes to control the mosquito population to prevent a global spread.

When contacted, MOH said it will be issuing an advisory soon.

About the Zika virus

What is the Zika virus?

The virus first got its name from the Zika forest in Uganda where scientists first identified it in 1947. It is spread by the Aedes mosquito, which also spreads the dengue and chikungunya viruses.

What are the signs and symptoms of a Zika infection?

Symptoms begin three to seven days after being bitten by an infected mosquito.

The illness is usually mild, with symptoms lasting for several days to a week. No death has been reported.

The current outbreak in Brazil resulted in 3,893 cases of microcephaly, where a number of babies have been born with abnormally small heads to mothers infected with the virus.

Can a Zika infection be treated?

There is no vaccine available.

Only the symptoms are treated.

To avoid getting infected, you can:
a. Use insect repellents that contain diethyltoluamide, also known as DEET.
b. Wear long-sleeved shirts and long pants or insect repellent-treated clothing.
c. Make sure there is no stagnant water around the home.

Source: US Centers for Disease Control and Prevention; National Environment Agency

Virus was in S-E Asia in 2013

Brazil has been experiencing its largest known outbreak of Zika.

Pregnant women who get infected could give birth to children who are prone to microcephaly, a disorder resulting in abnormally small heads, leading to developmental issues and sometimes death.

In Brazil, there have been 3,893 cases of microcephaly since last October. In contrast, there were fewer than 150 cases in all of 2014, reported AP.

While there have been no cases of the Zika virus reported in Singapore,it has been found in South-east Asia.

According to a journal published by the Ministry of Health (MOH) in 2014, two tourists from Canada and Germany were diagnosed with Zika infections after returning from Thailand in May and December of 2013 respectively. That year, Australia also reported a case of Zika infection in a citizen returning from Indonesia.

These reported cases might have indicated the presence of an undetected outbreak in these countries.